This site explores "being with and saying goodbye", the attitude that sustains professional practice, and that itself now needs sustenance

Question and Comment on Being With and Saying Goodbye

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3 thoughts on “Question and Comment on Being With and Saying Goodbye”

I’ve thoroughly enjoyed exploring this book, Andrew. Every chapter opens up things I would like to talk about, agree with, comment on etc. It may indeed apply to many professions where we meet and care for people or work with them, but as a counsellor of children and young people – one who sometimes refers to or liaises with CAMHS – and one of always liaises with parents and has family meetings to sort things out, this all made the most wonderful sense. The humour, wry comments and metaphors all felt both real and engaging. Nice of you to write a book just to make me feel better about how I work!

There are three reviews on the Karnac Books website (how the site works out an average score of 4/5 beats me). Need to conquer Amazon now.

Clare on 29/03/2016 17:17:05
(4 out of 5)

I know nothing about psychiatry, but I found this a gripping read.

I like the metaphors, similes and analogies. I like the anecdotes and the mini case histories (nicely breaking up the page) and the summaries. I like the humour and the irony. I like the straight talking, the directness of the language, the minimum of jargon. I like the personal warmth and the sincerity that come through so clearly. I like the ambition of it (attempting to change people’s mindsets and approaches) and the writer’s clear grasp of what his job entails. Not many people actually understand the complexity of their work at all well.

The author is consistently modest and unassuming, nevertheless it is totally clear to the reader that a) he knows what he’s talking about, and b) he has an admirable goal in mind in writing this book.

I love the way the book builds to the final chapter, which in my view is the best, and is a masterly piece of writing.

Perhaps this book isn’t for everybody, but surely, the more we all understand about how our minds and emotions work, the better we’ll be able to relate to each other and our children.

Steven Flower on 31/03/2016 18:46:46
(5 out of 5)

It is rare, in a professional book, to find that the voice of the author emerges quite so strongly and authentically as it does in Andrew West’s Being With and Saying Goodbye. This seems entirely appropriate as the book is an attempt to explore how clinicians may set about “being wit” their clients or patients in ways that honour the individuality of each patient and allow the clinician to do their work authentically. West argues strongly that there are aspects of contemporary healthcare systems and policies which actively undermine the potential for professionals to “be with” their patients. He identifies key aspects of the therapeutic attitude that he is advocating and gives many vignettes and examples that evidence his own thoughtfulness and integrity as a clinician who cares deeply about his work.

While this book is invaluable for psychiatrists, psychologists, psychotherapists and others working in the broad area of mental health, I think that anyone whose work involves helping relationships, with adults as well as children, will find much that is of value. It is expressed in a way that is unstuffy, very human and, at times, passionate. His patients and Services are lucky to have him. I hope that many others will take the time to “be with” him by reading the book.

Steven Flower
Jungian Analyst
Former Chair of British Association of Psychotherapists and British Psychotherapy Foundation

John Evers, retired consultant physician, Cornwall on 02/04/2016 15:58:10
(5 out of 5)

This excellent book fulfills several important functions. Firstly, it is a thoughtful and intensely felt exploration of the constituents of what a good therapeutic relationship between patient/client and professional should be, not just in the author’s own field of child and adolescent psychiatry but also in every clinical area; secondly, it is a heartfelt plea for professionals to be able to practise without the fear of being assailed by commissioners’ and managers’ financially driven targets; and thirdly, and in my view most importantly, it encourages clinicians to embrace uncertainty and doubt in their practice, in recognition of the fact that patients or clients coming to them need a trustworthy hand to hold while they jointly work out the nature of the problems, whether or not detailed assessment of them is likely to be helpful and what if any treatment may help. He is clear that the process of assessment and diagnosis (especially in mental health) can do more harm than good, unless its appropriateness or otherwise is properly understood. He eloquently expresses doubt about the great god of evidence-based medicine. Alongside his evidently deep thinking in and around his subject there is a wealth of practical advice on the process of contacting, addressing and ‘being with’ patients, as well as in the matter of disengaging positively and expectantly from what may be long-term clinical relationships
In a world where supermarket, instantly available medicine is being obsessively nurtured, Andrew West has sounded a clarion call for a return to the primacy of proper professional relationships, in which doubts may be shared, comfort sought and provided, and answers sometimes – but not always, and frequently imperfectly – provided.
This book should be carefully read by all those who claim to care about the future of health services, and especially those who once knew, but may have forgotten, that trust between patient/client and clinician is central to the prosperity and survival of those services.

I was recommended this book by a lecturer after a discussion about child and adolescent mental health. She specifically said “you will enjoy this book”- and I did. I am a MA Mental Health Nursing student with 3 years experience as a care assistant on an adolescent psychiatric ward, and this book clicked like none other.

Objectively, the book is written very well with a warm and friendly tone throughout. The metaphors used were so good, I made the effort to underline them to look back on in the future. The book is respectful of other approaches and makes some excellent and convincing arguments, made even more powerful by the wealth of experience and vignettes referred to by the Author.

Subjectively, I found it an easy and enjoyable read. I would recommend it for anyone working in healthcare, specifically those who have a lot of contact with adolescent patients. It has some reassuring messages such as being fallible, the benefit of silence, and wondering with your young person. It is also teaches a critical approach, not the typical ‘this study has A B and C biases’, but a critical approach to being a clinician. For example, one of the quotes that most resonated with me was: ‘if something cannot be shown to be helpful, that does not mean that it is not helpful’. In my training and nursing career I will surely tick many boxes and hopeful satisfy the much desired outcome measures, but more importantly I want to feel I have helped. If that help cannot be measured, though, I still helped and I hope those around me will value that.